Infertility Workup

 
 

A. Testing Ovulation Function

Note – you will not need a “test” of ovulation function if you do NOT have periods at all or only have a period if induced with prescription progesterone. In such cases, we skip to “additional” tests below.

Blood progesterone level
Drawn 5-7 days after ovulation
You do NOT need an office appointment to come in and have your blood drawn, but call 770-751-3600 to schedule the blood “draw”.

You must be certain of your ovulation timing for a blood progesterone level to be interpretable. Please use an ovulation test kit or a basal body temperature graph if you are not entirely sure of your ovulation. Additional Testing: If you do not ovulate or if your progesterone level is found to be low, we will recommend some or all of the following tests:
TSH (thyroid stimulating hormone) – drawn any cycle day
Fasting prolactin – drawn any cycle day
Fasting glucose and insulin – drawn any cycle day
HgbA1C – if not fasting (instead of the glucose and insulin)
AMH – drawn any cycle day
FSH (follicle stimulating hormone) – drawn on cycle day 2 or 3
Estradiol – drawn on cycle day 2 or 3

B. Testing Tubal Patency

There is only one basic test of tubal patency, a hysterosalpingogram or HSG. An HSG is an X-ray of your fallopian tubes and uterine cavity performed in a radiology department (outpatient or at a hospital). An HSG is typically done between cycle days 7-11 but could be done sooner if you have short cycles.
To schedule your HSG call after your period begins. They will go over additional details.

C. Testing For Male Factor Problems

The initial screening test is a semen analysis (SA) – The ICD-9 is Z31.41. Your partner needs to ejaculate into a specimen cup at home and get the specimen to the lab (at room temperature) within an hour. He needs to abstain from ejaculating for 2-3 days prior to the collection.

I recommend you take the specimen to one of the reproductive endocrine practices (RBA, ACRM, GRS, or Emory – see web links for locations). For your convenience these practices have both main offices and satellite offices. The satellite offices may not be able to handle a semen specimen 5 days a week, so please call the actual location you’re going to use to confirm they’ll be able to run the test.

RBA – http://www.rbaivf.com/
ACRM – http://www.atlantainfertilty.com
SGF – https://www.shadygrovefertility.com/
Emory – http://www.emoryhealthcare.org/reproductive-center/

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